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Arq. bras. med. vet. zootec. (Online) ; 72(5): 1625-1630, Sept.-Oct. 2020. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1131536


Magnesium sulphate (MS) and dioctyl sodium sulphosuccinate (DSS) are laxative drugs frequently used for the treatment of impactions. The aim of this study was to compare the effects of MS and DSS in fecal hydration, output and systemic hydration in healthy horses. Five healthy horses received 3 treatments with a 21-day interval. Treatment 1 was performed with administration of 4 liters of warm water; treatment 2: administration of 4 liters of warm water associated with 1g/kg of MS; and treatment 3: administration of 4 liters of warm water associated with 20mg/kg DSS. General and specific physical examination of the digestive system were performed, alongside with packed cell volume and total plasma protein measurement, abdominal ultrasonography and quantification of the amount and hydration of feces, before and 6, 12, 24, 36 and 48 hours after the treatments. No adverse effects were observed. The administration of laxatives promoted greater fecal output and hydration without resulting in systemic dehydration, yet no differences were observed between treatments. The absence of adverse effects of DSS demonstrates the safety of its use as a laxative drug at a dose of 20mg/kg. Studies comparing the effects of the laxative drugs in horses with large colon impaction are needed.(AU)

O sulfato de magnésio (SM) e o dioctil-sulfossuccinato de sódio (DSS) são drogas laxativas frequentemente utilizadas no tratamento da compactação. O objetivo deste estudo foi comparar os efeitos do SM e do DSS na hidratação e eliminação fecal, e na hidratação sistêmica de cavalos saudáveis. Cinco cavalos receberam três tratamentos, com intervalo de 21 dias. O tratamento 1 consistiu na administração de quatro litros de água morna; o tratamento 2: administração de quatro litros de água morna associada a 1g/kg de SM; e o tratamento 3: administração de quatro litros de água morna associada a 20mg/kg de DSS. Foram realizados exames físicos gerais e específicos do trato digestivo, hematócrito e proteína plasmática total, ultrassonografia abdominal e mensuração da quantidade e hidratação das fezes antes e após seis, 12, 24, 36 e 48 horas dos tratamentos. Não foram observados efeitos adversos. A administração de ambos os laxantes promoveu maior produção fecal e hidratação, sem resultar em desidratação sistêmica, entretanto não houve diferença entre os tratamentos. A ausência de efeitos adversos do DSS demonstra a segurança de seu uso como medicamento laxante na dose de 20mg/kg. São necessários estudos que comparem o efeito dos laxantes em equinos portadores de compactação de cólon.(AU)

Animals , Colon/pathology , Dioctyl Sulfosuccinic Acid/therapeutic use , Laxatives/administration & dosage , Fecal Impaction/therapy , Horses , Magnesium Sulfate/therapeutic use , Fecal Impaction/veterinary , Fluid Therapy/methods
Rev. Col. Bras. Cir ; 47: e20202406, 2020. tab, graf
Article in English | LILACS | ID: biblio-1136595


ABSTRACT Objective : to evaluate the clinical characteristics of patients with colorectal cancer under the age of 50 treated at a public hospital in Brasilia over 5 years. Methods: we conducted a longitudinal, retrospective study, with 184 patients undergoing surgical procedures at the Asa Norte Regional Hospital (HRAN), including those who underwent only biopsy, between January 2013 and January 2018. We divided the patients into two groups: under the age of 50 (n=39) and age equal to or greater than 50 years (n=145). We compared the groups as to age, sex, symptoms, time between symptom onset and diagnosis, family and personal history, tumor location, histopathological characteristics, applied surgical management, staging and mortality. Results: the group of patients under the age of 50 had more individuals with stage III and IV (p=0.041), more frequent poorly differentiated tumors (10.25% versus 3.52%; p=0.153), and higher incidences of compromised surgical margins (p=0.368), angiolymphatic (p=0.07) and perineural (p=0.007) invasion, which denotes more advanced disease in this group of patients. Conclusions: the study showed the low effectiveness of population screening methods for colorectal cancer currently used in this population, given the high incidence of the disease and late diagnosis in both groups.

RESUMO Objetivo: avaliar o perfil clínico de pacientes portadores de câncer colorretal com idade inferior a 50 anos atendidos em um hospital público de Brasília ao longo de 5 anos. Métodos: estudo longitudinal e retrospectivo. Foram incluídos 184 pacientes submetidos a procedimento cirúrgico no Hospital Regional da Asa Norte (HRAN), incluindo aqueles que realizaram apenas biópsia, entre janeiro de 2013 e janeiro de 2018. Os pacientes foram divididos em dois grupos: com idade inferior a 50 anos (n=39) e idade igual ou superior a 50 anos (n=145). Os grupos foram comparados em relação às seguintes variáveis: idade, gênero, sintomatologia, tempo entre início dos sintomas e diagnóstico, antecedentes familiares e pessoais, localização do tumor, características anatomopatológicas, conduta cirúrgica estabelecida, estadiamento e mortalidade. Resultados: no grupo dos pacientes com idade inferior a 50 anos houve maior concentração de indivíduos com estadiamento III e IV (p=0,041), foi mais frequente a presença de tumores pouco diferenciados (10,25% contra 3,52%; p=0,153), foram descritas maiores incidências de margens cirúrgicas comprometidas (p=0,368), invasão angiolinfática (p=0,07) e perineural (p=0,007), o que denota doença mais avançada nesse grupo de pacientes. Conclusões: o estudo evidenciou a baixa efetividade dos métodos de rastreamento populacional para câncer colorretal atualmente empregados nesta população, visto a elevada incidência da doença e ao diagnóstico tardio em ambos os grupos.

Humans , Male , Female , Adult , Young Adult , Carcinoma/pathology , Colorectal Neoplasms/pathology , Brazil/epidemiology , Carcinoma/surgery , Carcinoma/epidemiology , Colorectal Neoplasms/surgery , Colorectal Neoplasms/epidemiology , Retrospective Studies , Risk Factors , Longitudinal Studies , Age Factors , Colon/pathology , Middle Aged , Neoplasm Staging
Acta cir. bras ; 34(10): e201901004, Oct. 2019. graf
Article in English | LILACS | ID: biblio-1054674


Abstract Purpose: To evaluate the effects of infliximab on the inflammation of the colonic mucosa devoid from fecal stream. Methods: Twenty-four rats were submitted to a Hartmann's procedure. They remained for 12 weeks with the fecal derivation to development of diversion colitis on excluded colorectal stump. After this period, they were divided into 3 groups: one group received intervention with saline (2.0 mL / week), other group infliximab at doses of 5 mg/kg/week and the other 10 mg/kg/week for five consecutively weeks. Concluded the intervention period, the animals were euthanized to remove colon segments with and without fecal stream. Colitis was diagnosed by histological analysis and the degree of inflammation by validated score. The neutrophilic infiltrate was evaluated by tissue expression of myeloperoxidase identified by immunohistochemical. The tissue content of myeloperoxidase was measured by computer-assisted image analysis. Results: The inflammatory score was high in colonic segments without fecal stream. The intervention with infliximab reduced the inflammatory score in excluded colonic segments. The content of myeloperoxidase was reduced in colonic segments of animals treated with infliximab mainly in high concentrations. Conclusion: Intervention with infliximab reduced the inflammation and the neutrophil infiltrate in colonic segments devoid of the fecal stream.

Animals , Male , Gastrointestinal Agents/pharmacology , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Colitis/drug therapy , Infliximab/pharmacology , Time Factors , Image Processing, Computer-Assisted , Gastrointestinal Transit/drug effects , Immunohistochemistry , Reproducibility of Results , Rats, Wistar , Colitis/pathology , Colon/drug effects , Colon/pathology , Peroxidase/analysis , Neutrophil Infiltration/drug effects , Feces , Intestinal Mucosa/drug effects , Intestinal Mucosa/pathology
J. coloproctol. (Rio J., Impr.) ; 39(3): 223-230, June-Sept. 2019. tab
Article in English | LILACS | ID: biblio-1040328


ABSTRACT Background: Colorectal cancer survival is better in hereditary nonpolyposis colorectal cancer patients than in sporadic colorectal cancer patients and even for hereditary nonpolyposis colorectal cancer with colorectal cancer is not consensual that extensive colectomy is preferable to partial colectomy. This study analyzes and compares the long-term results of these two groups of patients submitted to curative subtotal colectomy or total colectomy. Methods: Between 2002 and 2018, 68 patients with colorectal cancer without familial adenomatous polyposis were submitted to a total or subtotal colectomy in a single tertiary center. The patients were divided in two groups: hereditary nonpolyposis colorectal cancer patients (with Amsterdam criteria) and sporadic colorectal cancer patients (the others). The presence of Amsterdam criteria for hereditary nonpolyposis colorectal cancer and germline mutation for mismatch repair genes was confirmed by clinical records. Results and survival were analyzed following surgery. Results: We obtained a sporadic colorectal cancer group with 31 patients and a hereditary nonpolyposis colorectal cancer group with 37 patients. The two groups differ in age but not in gender, tumor stage or surgical morbidity. The overall survival and disease-free survival were good in both groups but even better for hereditary nonpolyposis colorectal cancer group with statistical significance when comparing the two groups. Conclusion: Total or subtotal colectomy for colorectal cancer provides a good survival. These surgical procedures should be considered the first option for colorectal cancer in young hereditary non polyposis colorectal cancer patients. In those cases, they provide good long-term results, avoiding the risk of metachronous colorectal cancer and the surveillance is restricted only to the remaining need for rectum.

RESUMO Introdução: A sobrevivência do cancro colorretal é melhor em pacientes com cancro colorretal hereditário não associado a polipose do que em pacientes com cancro colorretal esporádico. Mesmo em casos de cancro colorretal hereditário sem polipose, a preferência pela colectomia total em relação à parcial não é consensual na literatura. Este estudo analisa e compara os resultados a longo prazo destes dois grupos de pacientes submetidos à colectomia curativa subtotal ou total. Métodos: Entre 2002 e 2018, 68 pacientes com cancro colorretal sem polipose adenomatosa familiar foram submetidos a colectomia total ou subtotal em um único centro terciário. Os pacientes foram divididos em dois grupos: aqueles com cancro colorretal hereditário sem polipose (de acordo com os critérios de Amsterdão) e os com cancro colorretal esporádico (os demais). Os critérios de Amsterdão para cancro colorretal hereditário sem polipose e a presença de mutação germinativa para os genes de reparação de ADN foram confirmados por consulta dos registros clínicos. Os resultados e a sobrevivência foram analisados após a cirurgia. Resultados: No presente estudo, 31 pacientes foram incluídos no grupo de cancro colorretal esporádico e 37 no grupo de cancro colorretal hereditário sem polipose. Diferenças significativas foram observadas em relação à idade, mas não ao gênero, estadio do tumor ou morbilidade cirúrgica. A sobrevivência global e a sobrevivência livre de doença foram boas em ambos os grupos, mas os resultados foram ainda melhores no grupo de cancro colorretal hereditário sem polipose, com significado estatístico. Conclusão: A colectomia total ou a colectomia subtotal para o cancro colorretal proporcionam uma boa sobrevivência e devem ser consideradas a primeira opção de tratamento em pacientes jovens com cancro colorretal hereditário sem polipose. Nestes pacientes, uma cirurgia cólica mais extensa permite a obtenção de bons resultados a longo prazo; reduz o risco de cancro colorretal metácrono e restringe a vigilância endoscópica ao reto remanescente.

Humans , Male , Female , Colorectal Neoplasms/surgery , Colorectal Neoplasms, Hereditary Nonpolyposis , Colectomy , Colon/pathology , DNA Mismatch Repair
J. coloproctol. (Rio J., Impr.) ; 39(3): 197-202, June-Sept. 2019. tab, graf, ilus
Article in English | LILACS | ID: biblio-1040329


ABSTRACT Background and aim: Right colon adenomas can easily missed with significant adenoma miss rate particularly when they are located behind the haustral folds and anatomical flexures. The aim of this study was to assess the significance of retroflexion technique in the right colon for improving adenoma detection rates compared with forward-view technique. Methods: A total of 200 patients scheduled for elective colonoscopy were recruited. During the standard forward-view examination, the colonoscope was withdrawn from the cecum to the hepatic flexure while under meticulous observation. Subsequently, the cecum was reintubated and the right side of the colon was assessed in the retroflexed-view to the hepatic flexure. The primary outcome of this study was comparison of the adenoma detection rates and adenoma miss rate of the retroflexed-view versus forward-view examination of the right colon. Results: Of the 200 enrolled patients, retroflexion was successful in 182 (91%). Forward-view examination of the right colon detected 88 polyps, of which 66 were adenomas yielding a polyp and adenoma detection rates of 25.5% and 19%, respectively. Additionally, retroflexion detected a further 30 polyps of which 23 were adenomas, accordingly improving the polyp and adenoma detection rates to 29.5% and 25%, respectively. Furthermore, the polyp and adenoma miss rate in the right colon was 24.1% and 25.8% respectively. Conclusion: Colonoscopy with right-sided retroflexion after forward-view examination significantly increases the detection of adenomas compared with standard forward-view examination with a high success rate and small risk of adverse events.

RESUMO Antecedentes e objetivo: Os adenomas do cólon direito podem não ser diagnosticados, apresentando uma elevada taxa de não detecção de adenoma, especialmente quando estão localizados atrás das pregas haustrais e flexões anatômicas. O objetivo deste estudo foi comparar, no cólon direito, a técnica de visualização retroflexionada com a técnica de visualização frontal quanto à taxa de detecção de adenoma. Métodos: Um total de 200 pacientes agendados para colonoscopia eletiva foram recrutados para o presente estudo. Durante o exame de visualização frontal padrão, o colonoscópio foi retirado do ceco em direção à flexão hepática sob observação meticulosa. Posteriormente, o ceco foi reintubado e o lado direito do cólon foi avaliado na visualização retroflexionada em direção à flexão hepática. O objetivo primário deste estudo foi comparar a taxa de detecção de adenoma e a taxa de não detecção de adenoma do exame de visualização retroflexionada e visualização frontal do cólon direito. Resultados: Dos 200 pacientes inscritos, a retroflexão foi bem sucedida em 182 (91%). A visualização frontal do cólon direito detectou 88 pólipos, dos quais 66 eram adenomas, com uma taxa de detecção de pólipos e taxa de detecção de adenoma de 25,5% e 19%, respectivamente. Além disso, a visualização retroflexionada detectou mais 30 pólipos, dos quais 23 eram adenomas, aumentando a taxa de detecção de pólipos e adenoma para 29,5% e 25%, respectivamente. Além disso, a taxa não detecção de pólipos e a taxa de não detecção de adenoma no cólon direito foram de 24,1% e 25,8%, respectivamente. Conclusão: A colonoscopia com visualização retroflexionada direita após visualização frontal aumenta significativamente a detecção de adenomas em comparação com a visualização frontal padrão, com uma alta taxa de sucesso e baixo risco de eventos adversos.

Humans , Male , Female , Adenoma/diagnosis , Colonoscopy , Polyps , Colon/pathology , Colonic Neoplasms
J. coloproctol. (Rio J., Impr.) ; 39(1): 33-40, Jan.-Mar. 2019. tab
Article in English | LILACS | ID: biblio-984633


ABSTRACT Background: Although herbal medicinal products are being used widely throughout the World, beneficial and harmful effects have not been well documented. Our aim was to evaluate the effects of Aloe Vera (AV) on colonic anastomosis healing. Material and methods: 112 albino Wistar rats were randomly assigned into five main groups: preoperative Aloe Vera Group (P), pre- and postoperative Aloe Vera Group (PP), Control Group (C), sham Aloe Vera Group (SA) and Sham Control Group (SC). Groups P, PP, and SA received 1.6 mL/kg per day Aloe Vera by orogastric feeding catheter for 1 month prior to the experiment. Groups P, PP, and C underwent anastomosis of the distal colon, and subgroups (n = 4) of each were sacrificed on postoperative day 3, 7, 14 and 21. Anastomotic bursting pressure, perianastomotic collagen content and histopathological changes were studied. Results: The SC Group had significantly higher ABP when compared with the SA Group (p = 0.0002), although hydroxyproline content showed no difference. When ABP was compared between anastomosis groups, it was found significantly lower in Aloe Vera groups on Day 3 (P3 vs. C3, p = 0.003 and PP3 vs. C3, p = 0.007). Hydroxyproline content was significantly lower in Group PP than Group C, also on Day 3 (p = 0.05). Significant difference was not detected after Day 3 in any of the study parameters. Conclusion: Aloe Vera decreased tissue collagen content in the early postoperative period. It is advisable to call into question the concomitant usage of conventional medicine and the herbal supplements for the surgeons in their clinical practice.

RESUMO Fundamentação: Embora os medicamentos à base de plantas sejam amplamente utilizados no mundo inteiro, seus efeitos (benéficos e prejudiciais) não estão bem documentados. Este estudo teve como objetivo avaliar os efeitos da Aloe vera (AV) na cicatrização de anastomoses colônicas. Material e métodos: 112 ratos Wistar albinos foram distribuídos aleatoriamente em cinco grupos principais: AV pré-operatório (P), AV pré e pós-operatório (PP), controle (C), sham AV (SA) e sham controle (SC). Os grupos P, PP e SA receberam AV em uma dose de 1,6 mL/kg por dia por sonda de alimentação orogástrica por 1 mês antes do experimento. Os grupos P, PP e C foram submetidos a anastomose do cólon distal. Subgrupos (n = 4) de cada grupo foram sacrificados no terceiro, sétimo, 14° e 21° dias pós-operatórios. Os seguintes parâmetros foram avaliados: pressão de ruptura anastomótica (PRA), conteúdo de colágeno perianastomótico e alterações histopatológicas. Resultados: O grupo SC apresentou PRA significativamente maior quando comparado ao grupo SA (p = 0,0002), embora o conteúdo de hidroxiprolina não tenha apresentado diferença. Ao comparar a PRA entre os grupos de anastomose, ela foi significativamente menor no terceiro dia nos grupos que usaram AV (P3 vs. C3, p = 0,003 e PP3 vs. C3, p = 0,007). No terceiro dia, o teor de hidroxiprolina foi significativamente menor no grupo PP do que no grupo C (p = 0,05). Após o terceiro dia, não se observou diferença significativa em nenhum dos parâmetros do estudo. Conclusão: O uso de AV diminuiu o conteúdo de colágeno tecidual no período pós-operatório imediato. É aconselhável questionar o uso concomitante da medicina convencional e suplementos fitoterápicos na prática clínica.

Animals , Rats , Anastomosis, Surgical/rehabilitation , Aloe , Wound Healing , Rats, Wistar , Colon/pathology , Phytotherapeutic Drugs , Hydroxyproline
ABCD arq. bras. cir. dig ; 32(1): e1417, 2019. tab, graf
Article in English | LILACS | ID: biblio-973379


ABSTRACT Background : Short bowel syndrome is a harmful condition that needs experimental research. Aim: To assess the impact of the ileocecal valve removal in a model of short bowel syndrome, in order to investigate the evolution of the colon under this circumstance. Method: Fifteen Wistar rats were equitable divided into: Control (Sham), Group I (70% enterectomy preserving ileocecal valve) and Group II (70% enterectomy excluding ileocecal valve). After enterectomy was performed jejunoileal or jejunocecal anastomosis and sacrificed the animals on 30th postoperative day for histomorphometric study of the colon. During this period, was observed the clinical evolution of the animals weekly including body weight measurement. Results: Group I and II presented progressive loss of weight. In Group I was observed diarrhea, perineal hyperemia and purple color of the colon during autopsy. Histomorphometry assay showed hypertrophy and hyperplasia of colon mucosa in Group I. In Group II the colon wall was thicker due to hypertrophy and muscular hyperplasia, and in mucosa vascular proliferation and inflammatory infiltrate were intense. Conclusion : This short bowel syndrome model is relevant and achieve 100% of survival. Animal's weight loss was not altered by the presence or exclusion of the ileocecal valve. Animals with 70% of small bowel removal and presence of the ileocecal valve attained a better clinical evolution and histological colon adaptation than those without ileocecal valve.

RESUMO Racional: Síndrome do intestino curto é condição clínica crítica e que precisa de pesquisa experimental. Objetivo: Avaliar o impacto da remoção da válvula ileocecal em um modelo de síndrome do intestino curto para investigar o comportamento do cólon nesta circunstância. Método: Quinze ratos Wistar foram divididos em três grupos de cinco: Controle (Sham), grupo I (enterectomia de 70% com preservação da válvula ileocecal), e grupo II (70% enterectomia de 70% excluindo a válvula ileocecal). Após a enterectomia foi restabelecido o trânsito com anastomose jejunoileal no grupo I e jejunocecal no grupo II. Os animais foram sacrificados no 30º dia do pós-operatório para histomorfometria do cólon. Durante este período, observou-se a evolução clínica semanal, incluindo a medição do peso corporal. Resultados: Grupos I e II apresentaram perda progressiva de peso. No grupo I houve diarreia, períneo hiperemiado e cor violácea do cólon durante a autópsia. A histomorfometria mostrou hipertrofia e hiperplasia da mucosa do cólon no grupo I. No grupo II a parede do cólon estava mais espessa devido à hipertrofia e hiperplasia das camadas muscular e mucosa onde a proliferação vascular e infiltração inflamatória foi intensa. Conclusão: Este modelo é factível e atingiu 100% de sobrevida. A perda de peso não foi alterada pela presença ou exclusão da válvula ileocecal. Animais com remoção de 70% do intestino delgado e presença da válvula ileocecal apresentaram melhor evolução clínica e adaptação histológica do cólon que os sem válvula ileocecal.

Animals , Male , Short Bowel Syndrome/surgery , Disease Models, Animal , Ileocecal Valve/surgery , Intestine, Small/surgery , Short Bowel Syndrome/pathology , Time Factors , Biopsy , Body Weight , Jejunoileal Bypass/methods , Random Allocation , Reproducibility of Results , Treatment Outcome , Rats, Wistar , Colon/surgery , Colon/pathology , Ileocecal Valve/pathology , Intestinal Mucosa/surgery , Intestinal Mucosa/pathology , Intestine, Small/pathology
Acta cir. bras ; 34(4): e201900406, 2019. tab, graf
Article in English | LILACS | ID: biblio-1001085


Abstract Purpose: To evaluate the inflammatory reaction and measure the content of mucins, in the colonic mucosa without fecal stream submit to intervention with mesalazine. Methods: Twenty-four rats were submitted to a left colostomy and a distal mucous fistula and divided into two groups according to euthanasia to be performed two or four weeks. Each group was divided into two subgroups according daily application of enemas containing saline or mesalazine at 1.0 g/kg/day. Colitis was diagnosed by histological analysis and the inflammatory reaction by validated score. Acidic mucins and neutral mucins were determined with the alcian-blue and periodic acid of Schiff techniques, respectively. Sulfomucin and sialomucin were identified by high iron diamine-alcian blue technique. The tissue contents of mucins were quantified by computer-assisted image analysis. Mann-Whitney test was used to analyze the results establishing the level of significance of 5%. Results: Enemas with mesalazine in colonic segments without fecal stream decreased the inflammation score and increased the tissue content of all subtypes of mucins. The increase of tissue content of neutral, acid and sulfomucin was related to the time of intervention. Conclusion: Mesalazine enemas reduce the inflammatory process and preserve the content of mucins in colonic mucosa devoid of fecal stream.

Animals , Male , Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Colon/drug effects , Mesalamine/pharmacology , Enema/methods , Mucins/analysis , Time Factors , Image Processing, Computer-Assisted , Gastrointestinal Transit , Colostomy , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Reproducibility of Results , Treatment Outcome , Rats, Wistar , Colitis/pathology , Colitis/prevention & control , Colon/metabolism , Colon/pathology , Oxidative Stress , Mesalamine/therapeutic use , Feces , Histocytochemistry , Intestinal Mucosa/drug effects , Intestinal Mucosa/metabolism , Intestinal Mucosa/pathology , Mucins/drug effects
J. coloproctol. (Rio J., Impr.) ; 38(4): 309-313, Oct.-Dec. 2018. tab, graf
Article in English | LILACS | ID: biblio-975977


ABSTRACT Ulcerative colitis is a chronic inflammatory condition of the colon with an unknown etiology. In this study, we aimed to evaluate the therapeutic effects of Cupressus sempervirens extract on the healing of acetic acid-induced ulcerative colitis in rat. Fifty-five male rats divided into five equal treatment groups were used for this study and received the following treatments: Group 1, 250 mg/kg asacol; Group 2, 1 ml gel base (carboxymethyl cellulose); Group 3, 0.5% gel form of C. sempervirens extract; Group 4, 1% gel form of C. sempervirens extract, and; Group 5, considered as negative control and received 1 ml of normal saline. Body weight changes, histopathological and antioxidant changes in the colon tissue were evaluated. Significant weight gain was observed in rats that received 1% gel extract of C. sempervirens. Significant superoxide dismutase activity was also detected in 0.5 and 1% gel extract groups compared to C. sempervirens extract, Asacol and in 1% gel extract groups compared to the gel base group. Furthermore, both gel extract groups had significant lower total antioxidant capacity compared to Asacol group. Several histopathological lesions including inflammation, ulceration, crypt disarray, and goblet cell depletion were detected in the different groups, however, the mean rank of pathological changes showed no significant difference among the five groups. In summary, our results showed that hydroalcoholic extracts of C. sempervirens leaves produces healing effects in acetic acid induced ulcerative colitis.

RESUMO A colite ulcerativa é uma doença inflamatória crônica do cólon com uma etiologia desconhecida. O objetivo deste estudo foi avaliar os efeitos terapêuticos do extrato de Cupressus sempervirens na cicatrização de colite ulcerativa induzida por ácido acético em ratos. Cinquenta e cinco ratos machos divididos em cinco grupos de tratamento iguais foram utilizados para este estudo e receberam os seguintes tratamentos: Grupo 1: 250 mg/kg de asacol; Grupo 2: 1 mL de gel base (carboximetilcelulose); Grupo 3: extrato de C. sempervirens a 0,5% em gel; Grupo 4: extrato de C. sempervirens a 1% em gel e; Grupo 5: considerado controle negativo que recebeu 1 mL de solução salina normal. Alterações no peso corporal, alterações histopatológicas e antioxidantes no tecido do cólon foram avaliadas. Ganho de peso significativo foi observado em ratos que receberam extrato em gel de C. sempervirens a 1%. Atividade significativa de superóxido dismutase também foi detectada em grupos de extrato em gel de 0,5 e 1% em comparação com o extrato de C. sempervirens, Asacol e em grupos de extrato em gel a 1% em comparação com o grupo base de gel. Além disso, ambos os grupos de extrato em gel apresentaram capacidade antioxidante total significativamente menor em comparação ao grupo Asacol. Várias lesões histopatológicas, incluindo inflamação, ulceração, desarranjo da cripta e depleção de células caliciformes foram detectadas nos diferentes grupos; no entanto, a classificação média de alterações patológicas não apresentou diferença significativa entre os cinco grupos. Em resumo, nossos resultados mostraram que extratos hidroalcoólicos de folhas de C. sempervirens produzem efeitos cicatrizantes em colite ulcerativa induzida por ácido acético.

Animals , Rats , Colitis, Ulcerative , Cupressus australis/therapeutic use , Colon/pathology , Antioxidants , Wound Healing/drug effects , Plant Extracts
Acta cir. bras ; 33(7): 565-576, July 2018. tab, graf
Article in English | LILACS | ID: biblio-949365


Abstract Purpose: To investigate the possible effects of argan oil on the healing of colorectal anastomoses. Methods: I n Group 1 (sham), laparotomy was performed and the colon was mobilized. In the control (Group 2) and argan oil (Group 3) groups, colonic resection and anastomosis were applied. To the control and sham groups, 2 mL of 0.9% NaCl was administred rectally, and in the argan oil group, 2 mL/day argan oil was applied rectally for 7 days. Results: The mean bursting pressures of the argan oil and sham groups were significantly higher than the values in the control group. A significant difference was determined between the tissue hydroxyproline and prolidase levels of control group and other groups. Histopathologically, argan oil showed significant beneficial effects on colonic wound healing. In the argan oil and sham groups, the tissue malondialdehyde and fluorescent oxidation product levels were found to be lower and total sulfhydryl levels were higher than the control group. Conclusions: The rectally administered argan oil was observed to have significantly ameliorated wound healing parameters and exerted a significant antioxidant effect. This is the first study in the literature about the beneficial effects of argan oil on colorectal anastomoses.

Animals , Female , Rectum/surgery , Wound Healing/drug effects , Plant Oils/therapeutic use , Colon/surgery , Anti-Inflammatory Agents/therapeutic use , Antioxidants/therapeutic use , Oxidoreductases/analysis , Rectum/pathology , Spectrophotometry , Anastomosis, Surgical , Random Allocation , Reproducibility of Results , Collagen/analysis , Treatment Outcome , Rats, Wistar , Colon/pathology , Oxidative Stress/drug effects , Dipeptidases/analysis , Surgical Wound/pathology , Surgical Wound/drug therapy , Hydroxyproline/analysis , Malondialdehyde/analysis
Prensa méd. argent ; 104(2): 73-78, 20180000. tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1370661


Introduccion: La cirugía robótica colorectal se llevó a cabo por primera vez en el Hospital Clínic de Barcelona en Enero de 2016. El objetivo de este estudio es presentar nuestra experiencia inicial en cirugía robótica de pacientes afectos de patología colorectal. Metodos: Esta es una revisión retrospectiva de los datos recogidos de forma prospectiva de los pacientes intervenidos de patología colorectal mediante cirugía robótica entre Enero y Diciembre 2016. Se obtuvieron para análisis las características de los pacientes y los datos tanto peri como postoperatorios. Resultados: Un total de 40 pacientes con una edad media de 69.3 años (42- 93) y un índice de masa corporal medio de 26.8 kg/m2 (15-37) fueron intervenidos mediante cirugía robótica de su patología colorectal. La indicación quirúrgica fue por patología maligna en el 90 % de los casos y patología benigna en el 10 %. La intervención más frecuente fue la sigmoidectomía (57.5 %), seguida de la hemicolectomía derecha (20 %), la resección anterior baja (12.5 %), la hemicolectomía izquierda (7.5 %) y la resección segmentaria de ángulo esplénico (2.5 %). El tiempo operatorio medio fue de 159.9 min (90-260). El número medio de ganglios resecados fue 18.1 (5-42). La estancia mediana fue de 4.6 días (2-13). No hubo ningún caso de conversión a cirugía abierta, únicamente hubo un caso convertido a cirugía laparoscópica (2.5 %) y el índice de fallos de sutura fue de 2.6%. Conclusiones: Aunque se trata de nuestra experiencia inicial, podemos considerar que la cirugía robótica es una técnica factible y segura en pacientes afectos de patología colorectal

ntroduction Robotic colorectal surgery was first performed at our institution in January 2016. The objective of this study is to present our initial experience with robotic colorectal surgery. Methods: This is a retrospective review of the prospectively collected data of all patients who underwent robotic colorectal surgery from January 2016 to December 2016. Baseline, perioperative, and postoperative data were obtained for analysis. Results: A total of 40 patients with a mean age of 69.3 years (42-93) and a body mass index of 26.8 kg/m2 (15-37) underwent robotic colorectal surgery between January and December 2016. The indication for surgery was malignancy in 90% and benign diseases in 10% of the patients. The most common operation was sigmoidectomy (57.5%) followed by right colectomy (20%), low anterior resection (12.5%), left colectomy (7.5%) and splenic flexure segmentary resection (2.5%). The mean operative time was 159.9 (90-260) minutes. The median number of lymph nodes harvested was 18.1 (5-42). The median duration of hospital stay was 4.6 days (2- 13). Conversion to laparoscopic surgery occurred in one case (2.5%) and anastomotic leakage rate was 2.6% Conclusions: Despite being our initial experience, we can consider robotic surgery as a safe and feasible technique for patients with colorectal diseases

Humans , Middle Aged , Aged , Aged, 80 and over , Rectum/pathology , Retrospective Studies , Colectomy/methods , Colon/pathology , Colorectal Surgery/methods , Minimally Invasive Surgical Procedures/methods , Robotic Surgical Procedures/methods , Perioperative Medicine
Acta cir. bras ; 33(4): 333-340, Apr. 2018. tab, graf
Article in English | LILACS | ID: biblio-886278


Abstract Purpose: To compare platelet rich plasma (PRP) and fibrin glue about the effect of anastomotic healing. Methods: Thirty six Wistar-Albino male rats diveded into 3 groups according to control(Group1), PRP (Group 2) and fibrin glue(Tisseel VH) (Group 3). The colon was transected with scissor and subsequently an end to end anastomosis was performed using continuous one layer 6/0 vicryl sutures. Postoperative 7th day effect of anastomotic healing measuring with tissue hydroxyproline(TH) level and anastomotic bursting pressure(ABP); moreover comparison of cytokine (IL-6 and IL-10) and procalcitonin levels on 1st,3rd and 7th days. Results: There was no statistically significant difference of the ABP and hydroxyproline levels between PRP and fibrin glue on the 7th day. There was no statistically significant difference between levels of proinflammatory cytokine (IL-6) (P=0.41), anti-inflammatory cytokine (IL-10) (P=0.35), and procalcitonin levels (P=0.63) on 1, 3 and 7 days. Conclusion: Fibrin glue and platelet rich plasma are shown to be effective in healing intestinal anastomoses without superior to each other.

Animals , Male , Wound Healing/drug effects , Hemostatics/pharmacology , Fibrin Tissue Adhesive/pharmacology , Platelet-Rich Plasma , Time Factors , Calcitonin/analysis , Anastomosis, Surgical , Reproducibility of Results , Cytokines/analysis , Treatment Outcome , Rats, Wistar , Colon/surgery , Colon/pathology , Hydroxyproline/analysis
Braz. j. med. biol. res ; 51(7): e7372, 2018. tab, graf
Article in English | LILACS | ID: biblio-951733


The effect of bisacodyl on the treatment of rats with slow transit constipation (STC) was studied. Forty-five female Wister rats were divided into control group, STC group, and STC bisacodyl group. The immunohistochemical method was used to determine interstitial cells of Cajal (ICC) and the expression of c-Kit protein. Body mass and the number of defecations were significantly decreased in the STC group compared with the control group on the 100th day after diphenoxylate administration, while dry weight of feces was significantly increased and the intestinal transit time was prolonged. There were significant differences in the number of defecations, dry weight of feces, and intestinal transit time among the three groups. The number of defecations was higher, dry weight of feces was lower, and intestinal transit time was shorter in the STC bisacodyl group compared to the STC group. In addition, ICC basement membrane dissolution occurred in the colon wall of the STC group. The connection between ICC and surrounding cells was destroyed, and the nucleus shrunken to different degrees. Moreover, c-Kit expression in the STC group was significantly lower than the control group. The connection between ICC and surrounding cells in the STC bisacodyl group was significantly stronger than the STC group, and the number of ICC and the expression of c-Kit were increased. Bisacodyl could reduce the severity of STC in rats by increasing the number of ICC and the expression of c-Kit.

Animals , Female , Rats , Bisacodyl/therapeutic use , Gastrointestinal Transit/drug effects , Cathartics/therapeutic use , Colon/metabolism , Proto-Oncogene Proteins c-kit/metabolism , Constipation/drug therapy , Interstitial Cells of Cajal/drug effects , Gastrointestinal Transit/physiology , Immunohistochemistry , Rats, Wistar , Colon/drug effects , Colon/pathology , Constipation/physiopathology , Constipation/metabolism , Interstitial Cells of Cajal/metabolism , Interstitial Cells of Cajal/pathology
Acta cir. bras ; 32(6): 440-448, June 2017. tab, graf
Article in English | LILACS | ID: biblio-886209


Abstract Purpose: To investigate if fluorescein fluorescent test can predict dehiscence in a model of ischemic colonic anastomosis in rats. Methods: This experimental controlled trial randomly assigned 55 rats to four groups. Anastomoses were performed in non-ischemic colon segments (control group) and in ischemic colon segments measuring 1, 2 or 3 cm long (groups 1, 2 and 3, respectively). Fluorescein was injected and the tissues were examined under ultraviolet light. Seven days later, a second-look surgery was performed to check for the presence or absence of anastomosis dehiscence. Results: Twenty-four rats presented anastomotic dehiscence during the second-look surgery. Reticular and nonfluorescent patterns were significantly associated with the occurrence of anastomotic dehiscence. Fluorescein fluorescence had a sensitivity of 95.8%, specificity of 89.2%, positive predictive value of 88.4%, negative predictive value of 96.2%, and accuracy of 92.3% to predict anastomotic dehiscence. Conclusion: Fluorescein fluorescent test can accurately predict leak in a model of ischemic colonic anastomosis in rats.

Animals , Male , Rats , Surgical Wound Dehiscence/diagnosis , Anastomosis, Surgical , Colon/surgery , Fluorescein , Fluorescent Dyes , Ischemia/surgery , Wound Healing , Colon/blood supply , Colon/pathology
Acta cir. bras ; 32(4): 319-324, Apr. 2017. graf
Article in English | LILACS | ID: biblio-837703


Abstract Purpose: To describe a new model of actinic enteritis that does not use radiotherapy machines. Methods: Sixteen Wistar rats were divided into four groups, consisting of four animals each: control (group A), two weeks after irradiation (group B), five weeks after irradiation (group C) and eight weeks after irradiation (group D). Animals were given a 10Gy radiation from a Cobalt-60 natural source in a nuclear technology research center. Protections of the surrounding tissues were obtained through the usage of plumb devices with a hole in the center, which served as a collimator. We obtained irradiated and non-irradiated colons from each animal. Results: In group B we found an important inflammatory response in the irradiated colon, which appeared in a reduced way in group C and was minimal in group D, in which we found a relevant collagen submucosal deposition/fibrosis. In all groups, the non-irradiated colon had a lower pathological damage in comparison with the irradiated colon. Conclusion: We thus described an efficient and feasible technique for obtaining an animal model of actinic enteritis.

Animals , Female , Rats , Radiation Injuries, Experimental/pathology , Cobalt Radioisotopes , Colon/radiation effects , Dose-Response Relationship, Radiation , Rats, Wistar , Colon/pathology , Disease Models, Animal
Acta cir. bras ; 32(3): 182-193, Mar. 2017. tab, graf
Article in English | LILACS | ID: biblio-837695


Abstract Purpose: To measure the tissue sulfomucin and sialomucin content of the colon mucosa without fecal flow, subjected to intervention with curcumin, and the influence of the concentration used and the intervention time. Methods: Thirty-six rats were subjected to proximal right colostomy and distal mucous fistula. They were divided into two groups according to whether sacrifice was performed two or four weeks after the intervention. Each group was divided into three subgroups according to the enema applied daily: saline alone; curcumin at 50 mg/kg/day or curcumin at 200 mg/kg/day. Acid mucins were diagnosed using the Alcian blue technique. The mucin content was quantified by means of computer-assisted image analysis. The significance level of 5% was used throughout (p < 0.05). Results: There were dose-related increases in the quantities of sulfomucins in the animals subjected to interventions with curcumin, both after two weeks (p < 0.00001) and after four weeks (p < 0.00001). There were increases in sialomucin quantity that were concentration-related (p < 0.00001) and time-related (p < 0.00001). Conclusion: Curcumin enemas increase the quantity of acid mucins in the intestinal flow in the excluded colon, with dose and time dependency.

Animals , Male , Plant Extracts/administration & dosage , Colon/drug effects , Colon/chemistry , Intestinal Mucosa/drug effects , Intestinal Mucosa/chemistry , Mucins/analysis , Reference Values , Time Factors , Image Processing, Computer-Assisted , Plant Oils/administration & dosage , Gastrointestinal Transit/drug effects , Colostomy , Reproducibility of Results , Rats, Wistar , Colitis/pathology , Colitis/drug therapy , Colon/pathology , Curcuma , Enema/methods , Sialomucins/drug effects , Feces , Intestinal Mucosa/pathology , Mucins/drug effects
Acta cir. bras ; 32(1): 65-73, Jan. 2017. graf
Article in English | LILACS | ID: biblio-837665


Abstract Purpose: To evaluate the inflammatory intensity and measure the tissue content of the proteins claudin-3 and occludin in the colonic mucosa without fecal stream submit to intervention with curcumin. Methods: Thirty-six rats were submitted to a proximal colostomy and a distal mucous fistula and divided into two groups according to sacrifice to be performed two or four weeks. Each group was divided into three subgroups according daily application of enemas containing saline, curcumin at 50 mg/kg/day or 200 mg/kg/day. Colitis was diagnosed by histological analysis. Claudin-3 and occludin were determined by immunohistochemistry. The tissue content of claudin-3 and occludin were quantified by computer-assisted image analysis. Mann-Whitney, Student t and ANOVA tests were used to analyze the results establishing the level of significance of 5% for both (p<0.05). Results: Curcumin at both concentrations reduces the inflammation and preserves the tissue content of the proteins claudin-3 and occludin, which was related to the concentration used and to the time of the intervention. Conclusion: The application of enemas with curcumin reduces inflammation and preserves the tissue content of the proteins claudin-3 and occludin in the colonic mucosa devoid from the fecal stream.

Animals , Rats , Plant Oils/pharmacology , Colon/chemistry , Curcuma/chemistry , Enema/methods , Occludin/analysis , Claudin-3/analysis , Intestinal Mucosa/chemistry , Immunohistochemistry , Colostomy , Rats, Wistar , Colon/drug effects , Colon/pathology , Feces , Intestinal Mucosa/drug effects , Intestinal Mucosa/pathology
J. coloproctol. (Rio J., Impr.) ; 36(4): 189-195, Oct.-Dec. 2016. tab, graf
Article in English | LILACS | ID: biblio-829114


Objective: To investigate the effects of hydroalcoholic extract of Ziziphus jujuba on the histopathological, tissue oxidative stress and inflammation plus to antioxidant pathways of colon tissue in rat with induced Ulcerative colitis. Materials and methods: Ulcerative colitis was induced in 80 rats those divided into 8 equal groups. Group 1 and 2 were negative controls receiving 1 mL/day of normal saline in enema and oral; group 3 and 4 as positive control 1 and 2 received 10 mg/kg of intra-colonic asacol and oral mesalazine; groups 5 and 6 received 20% and 40% of hydroalcoholic extract of Z. jujuba trans-rectally; group 7 and 8 received 1500 and 3000 mg/kg of hydroalcoholic extract of Z. jujuba orally, respectively. After 7 days, animals were evaluated for colon tissue histopathology, levels of malondialdehyde and IL-1ß, and activities of superoxide dismutase, glutathione peroxidase and myeloperoxidase in colon tissue. Results: Hydroalcoholic extract of Z. jujuba in both forms of trans-rectal and oral administration especially in the higher doses could result into a more healing effect in damaged colonic tissue, more reduce glutathione peroxidase and IL-1ß; level. Also, these two doses (gel 40% and oral 3000 mg/kg) could more decrease the myeloperoxidase activity and stimulate superoxide dismutase and glutathione peroxidase activities. Also, gel 40% in transrectal administration was more potent than administration 3000 mg/kg in oral. Conclusion: The results of the present study indicated that Z. jujube may be considered as a treatment of choice for Ulcerative colitis especially in gel form and also in dose-dependent pattern.

Objetivo: Investigar os efeitos do extrato hidroalcoólico de Ziziphus jujuba no estresse oxidativo em tecido ao nível histopatológico e na inflamação, juntamente com as vias antioxidantes em tecido de cólon em ratos com colite ulcerativa induzida. Materiais e métodos: Induzimos colite ulcerativa em 80 ratos, divididos em 8 grupos iguais. Os grupos 1 e 2 eram controles negativos que receberam 1 mL/dia de salina normal em enema e por via oral; os grupos 3 e 4 eram controles positivos para 1 e 2 e receberam 10 mg/kg de asacol por via intracolônica e mesalazina oral; os grupos 5 e 6 receberam gel a 20% e 40% de extrato hidroalcoólico de Z. jujuba por via trans-retal; os grupos 7 e 8 receberam 1500 e 3000 mg/kg de extrato hidroalcoólico de Z. jujuba por via oral, respectivamente. Transcorridos 7 dias, os animais foram avaliados para histopatologia de tecido de cólon, níveis de malonildialdeído e IL-1ß, e atividades de superóxido dismutase, glutátion peroxidase e mieloperoxidase no tecido colônico. Resultados: O uso do extrato hidroalcoólico de Z. jujuba, tanto na forma transretal como oral, e em especial nas doses mais altas, resultou em um efeito de cicatrização mais intensa no tecido colônico lesionado, e em maior redução nos níveis de glutátion peroxidase IL-1ß. Além disso, essas duas doses (gel a 40% e 3000 mg/kg por via oral) diminuíram ainda mais a atividade de mieloperoxidase e estimularam as atividades de superóxido dismutase e glutátion peroxidase. Outro achado do estudo foi que o gel a 40% por administração trans-retal se mostrou mais potente do que a administração oral de 3000 mg/kg. Conclusão: Os resultados do presente estudo sugerem que Z. jujuba pode ser considerado como tratamento de escolha para colite ulcerativa, sobretudo em forma de gel e também em um padrão proporcional à dose administrada.

Animals , Rats , Plant Extracts , Colitis, Ulcerative , Colitis, Ulcerative/drug therapy , Hydroalcoholic Solution , Oxidative Stress , Plant Preparations , Ziziphus , Inflammation , Phytotherapy , Plants, Medicinal , Colon , Colon/pathology , Peroxidase , Acetic Acid , Acetic Acid/administration & dosage , Models, Animal , Interleukin-1beta , Animals, Laboratory , Malondialdehyde , Antioxidants
J. coloproctol. (Rio J., Impr.) ; 36(2): 86-90, Apr-Jun. 2016. graf, ilus
Article in English | LILACS | ID: lil-785861


Introduction: Proctologic examination is a deeply intimate procedure which deals with a body area in which prejudices, taboos and constraints prevail, and may also relate to previous trauma; yet this procedure is of paramount importance for the investigation of patients with symptoms that foretell pathologies associated with distal colon, rectum and anus. Objectives: This study aimed to analyze all cases scheduled of rigid proctosigmoidoscopy performed by the Coloproctology Service, Hospital Santa Marcelina, in 8 of its 10 years of residency in the specialty. Materials and methods: We analyzed mean age, gender distribution, device's height of reach in relation to the anal verge, the percentage of abnormal tests stratified to perform, or not perform, anoscopy and proctosigmoidoscopy, and major diseases detected. Results: 844 rigid proctosigmoidoscopy procedures scheduled and performed by the Coloproctology Service, Hospital Santa Marcelina, between September 2006 and August 2014, were analyzed. The distribution was similar between genders and the mean age was 51.2 years. With respect to the device's height of reach from the anal verge, these values were stratified as follows: distance reached >15 cm, 10-15 cm, and <10 cm from the anal verge. Distances >15 cm from the anal verge were attained in 692 (82% of RR) tests, between 10 and 15 cm in 94 (11.1%) tests, and <10 cm in 58 (6.9%) tests. Conclusion: In this study, it was found that proctology examination and rigid proctosigmoidoscopy are mandatory procedures in cases of symptoms depending on these practices.

Introdução: O exame proctológico, apesar de profundamente íntimo e de lidar com área do corpo na qual imperam preconceitos, tabus e constrangimento, podendo inclusive relacionar-se a traumas prévios, é de suma importância para a investigação de pacientes com sintomas que predizem patologias associadas ao cólon distal, reto e ânus. Objetivos: Analisar todos os casos de retossigmoidoscopias rígidas realizadas de forma agendada pelo serviço de Coloproctologia do Hospital Santa Marcelina em 8 de seus 10 anos de residência médica na especialidade. Materiais e métodos: Analisou-se a média de idade, distribuição por sexo, altura de alcance do aparelho em relação à borda anal, percentagem de exames anormais com estratificação quando realizado ou não a anuscopia e retossigmoidoscopia e as principais doenças detectadas. Resultados: Foram avaliadas 844 retossigmoidoscopias rígidas realizadas pelo serviço de Coloproctologia do Hospital santa Marcelina, de forma agendada, entre setembro de 2006 e agosto de 2014. A distribuição foi semelhante entre os sexos e a média de idade foi de 51,2 anos. Com relação à altura em relação à borda anal, estratificou-se esses valores em maior que 15 cm, entre 10 e 15 cm da borda anal e alcance inferior a 10 cm da borda anal. Em 692 exames foi possível alcance superior a 15 cm da borda anal (82% das RR), em 94 (11,1%) entre 10 e 15 cm, e em 58 (6,9%) exames, abaixo de 10 cm. Conclusão Verificou-se em nosso estudo que o exame proctológico e a retossigmoidoscopia rígida são mandatório em casos de sintomatologia que assim o necessitem.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Anal Canal/surgery , Rectum/surgery , Sigmoidoscopy , Colon/surgery , Anal Canal/pathology , Physical Examination , Rectum/pathology , Proctoscopy , Sigmoidoscopy/adverse effects , Sigmoidoscopy/statistics & numerical data , Elective Surgical Procedures , Colon/pathology , Colonography, Computed Tomographic , Age and Sex Distribution , Contraindications, Procedure